Nurses on front lines: ‘People do not take this seriously’
One nurse misses smiling at patients. The required face mask takes away some personality.
Another said she tries to connect with patients with her eyes.
And one said she’s still struggling to sleep, but is ready to get back to work.
For months, trauma and death have been their companions.
But these nurses keep going. Some are compelled to serve because they have the skills. Some feel a deep human connection to their patients, who wait to see them return on their shifts the next day, and the next.
These nurses have seen the worst, and they don’t want that to happen in Arizona.
Seven nurses told The Arizona Republic what it was like inside hospitals in early hot spots in New York and New Jersey, and what it’s like in Arizona hospitals now.
For these nurses, the situation here certainly isn’t easy, but the situation isn’t at the levels they saw in East
Coast hospitals earlier in the pandemic.
Some normally work in Arizona and took leaves of absence to go help out. Others are traveling nurses who have now been dispatched to Arizona as the state has emerged as a new hot spot.
They described beyond-busy hospitals in New York and New Jersey, with patient after patient hooked up to ventilators and few discharges.
Because these spots were hit early, they had little time to prepare with enough hospital resources and staff to manage the growing number of patients. Health care workers didn’t know which treatments would work to treat this new disease.
“It was like chaos a lot of the times, and people were dying a lot, left and right. Every day, people were dying,” said Marcie Gest, a nurse who worked at a hospital in Lakewood, New Jersey, and is now working back in Arizona.
Still, many of these nurses said they were frustrated to see Arizona crop up as a hot spot despite the clear examples, from places they worked in other states, of the bad that can happen when the virus takes hold of a community.
Several wanted one message to come through clearly: Arizonans need to take COVID-19 seriously. They should be wearing masks and social distancing to help health care workers who are working hard to keep up with the virus.
Janet Campbell-Vincent started seeing her Facebook feed fill up with people out and about while she was working as a nurse in Brooklyn. New York City was empty while Arizona was starting to reopen.
“I’m just like, oh my God, it’s just going to get out of hand if people aren’t being careful about this, and some people are, but it seems like it’s definitely not enough, as you can tell by how our hospitals are exploding with patients,” she said. “People do not take this seriously enough.”
Treating COVID-19 patients takes round-the-clock, intensive nursing care, they said, and battling a new disease continues to confound. Patients will go from fine one minute to tanking the next.
These nurses are dealing with the trauma they’ve seen for months as they continue to work long hours with little chance to reflect on what they’ve endured.
They have gotten sick themselves, or seen their colleagues catch the virus.
Here are their stories.
Raquel Bertucci: Day after day of death
Arriving at Elmhurst Hospital in New York City was like being “dropped in the middle of the war zone,” said Raquel Bertucci, an Arizona-based nurse who volunteered to work in the pandemic hot spot.
As Arizona began to shut down in March and elective surgeries were halted, her hours here were cut. It was time to go help where help was needed.
She would start a shift at 7 a.m. and have nine or 10 patients to attend to. By the time she would get to the fourth patient, sometimes the patient would be dead before she could help. It was day after day of death, unlike anything she’d ever seen.
The disease wiped out entire families. Nurses at Elmhurst weren’t able to save many people, especially early on, and resources were stretched thin, she said.
Scans showed lungs that looked like popcorn. There were smells she had never smelled. Several patients’ eyes protruded out of their sockets.
She tried to provide a personal touch to patients and their families. For one, she set up her own phone with FaceTime for many hours in the room so family could be there as the patient was dying.
For another, family members asked her to respect their beliefs and help perform the death rituals they would normally do if visitors were allowed. She did.
In the 11 weeks she was there, she had only three patients survive.
She’s been back in Arizona for about two weeks. She thinks she’s experiencing some post-traumatic stress and isn’t sleeping well.
She has been slowly easing back into work, taking shifts that aren’t the critical care she was doing in New York. It’s not as busy here in hospitals as it was in New York, and the hospitals seem more prepared to handle the incoming patients, she said.
Typically, summer is a slow season for the Phoenix area hospitals where she works. Snowbirds have gone home, and flu season wanes. But not this year.
She’s on deck to be deployed as a crisis nurse to Texas. She’s signed up as a reservist for a medical staffing service. The call could come any day now. Anybody who worked in New York City to fight COVID-19 should be considered an expert in treating the disease, she said. She’s ready to share that expertise.
“My saving grace to go is I know I can go and jump in any situation regarding COVID-19, and do a good job and step up to whatever plate might be put in front of me, and I’ll be able to navigate my way through.”
Janet Campbell-Vincent: ‘You don’t have time to process’
Janet Campbell-Vincent, an Arizona ICU nurse, got the ultimate 50th birthday present: exposure to COVID-19.
Back in March, her co-worker returned to the U.S. from Europe. It turned out she was an asymptomatic carrier of the virus, and Campbell-Vincent became sick a few days after being exposed. She had a fever, dry cough, body pain, fatigue and difficulty doing any kind of activity.
When she left for New York to help health care workers there fight the virus in May, she was still not at 100%. She noticed it on a layover in Denver, with its famous high altitude: It was still sometimes hard to breathe.
But she wanted to learn more about how to treat these patients, and she wanted to help out. By the time she left New York Community Hospital in Brooklyn at the end of June, it had largely non-COVID-19 patients, as the pandemic began to wane there.
She’s seen more lives lost in the past few months than at any other time in her career. She’s never seen so many patients code. She worked during H1N1, but COVID-19 is “easily 10 times worse” in terms of the deaths she’s seen.
“You don’t have time to process,” she said. “You literally just kind of shove it down and move on to your next patient that you can help. That’s the reality of it right now. Hopefully it doesn’t make me too cold to death or other people’s suffering; I don’t want that to occur. But we as nurses just don’t have time to process it.”
Because it was so busy, nurses would communicate mostly with one family member to update them on their loved one’s situation, she said.
In one instance, she recalled nurses trying and trying to reach their contact as a patient was in the final stages of the disease. They kept leaving messages but weren’t hearing back. The patient died before they could get in touch with the family. They later learned the relative who was their point of contact also had become ill with COVID-19 and was hospitalized.
She returned to work in Arizona at the beginning of July, as the situation was heating up here. When she went back to HonorHealth in Scottsdale, the ICU was full.
“It is bursting at the seams. There is
no doubt about that,” Campbell-Vincent said. “And staffing — I mean, normally, if we’re busy on an average day, we may have seven ICU nurses. We’re using 17 each shift.”
They’re bringing in travel nurses to help with staffing concerns here, much like Campbell-Vincent was brought in to aid a hard-hit New York hospital earlier.
To minimize time spent around patients for safety reasons, they’ve started putting baby monitors in rooms to allow nurses to keep an eye on people, she said. But nurses notice so many little things in person that a baby monitor might not pick up.
The patients she’s seeing here are younger, she said.
“We’ve got people that are in their 20s, people that you would not expect to have an issue overcoming a basic virus. The reality is, this is not your basic virus.”
And she thinks this is just the beginning.
“I’m not looking forward to the next few months, that’s for sure. I don’t know how we’re going to get through it.”
Jess Esperti:
She remembers the shoes
She and the patient had the same bright green and black Nike shoes.
That’s all Jess Esperti had to connect with him in New York: He had the same pair of Nikes she had, sitting beside his bed as he lay there, fighting the disease.
With no visitors allowed, and most patients sedated and on ventilators, nurses like Esperti could learn little about the people they were working to save.
“I knew nothing about him or where he came from,” she said. “It’s nice to be able to know those things as a human. And I know I’m not alone in that. As nurses, we like to know that information.”
Esperti, a 41-year-old critical care nurse from Arizona, worked at Elmhurst Hospital in Queens, the epicenter of the epicenter, from early April to early June. She returned to work at a hospital system in the Phoenix area two weeks after she came back from New York.
She’s seen the hospitals here pick up, and it’s definitely busier than normal. But it’s not Elmhurst.
“It’s really hard to describe because I was in New York and I saw what it was, so now it’s kind of like, ‘Oh, we’re still
doing good, Arizona,’ like we’re not anywhere close to what that was,” she said.
Esperti lost a COVID-19-positive patient last week whose oxygen levels were extremely low and whose chest scan was “horrible.” The woman needed to be on a BiPAP machine pushing air into her lungs but didn’t want to be on it indefinitely.
She was scared and didn’t know what to do, whether she wanted to keep fighting. Esperti got the woman’s family, her kids and grandkids, on a conference call, where they talked through what could come next. The woman felt a lot better after talking with her family, Esperti said.
She decided she didn’t want to live with a BiPAP mask on for the rest of her life. And if that meant she died, then so be it, Esperti said.
“She died probably within about 15 minutes. But my takeaway from that was, at least I could get family involved.”
At least here, Esperti isn’t so stretched thin, so she can provide that human touch that means so much.
At least here, some people are recovering from the disease. They’re being discharged. Even a 92-year-old woman who tested positive for both COVID-19 and the flu was discharged on the third day, Esperti said.
Health care workers have learned more about how to treat these patients — to avoid ventilators unless absolutely necessary, to put patients on their bellies to help them breathe better.
In New York, not a single person she treated was discharged.
“Not one. They all ended up dying. It was insane.”
Esperti hasn’t had time to process all of the trauma she saw in New York. She worked so much while there, she had no time to reflect. And she jumped back in to work here, too.
She’s heard from nurse friends who have had their first panic attacks, who have experienced overwhelming anxiety and sadness.
She’s just waiting to see if it will all creep up on her in the same way in the future. Maybe she blocked it out, maybe she was able to disconnect. But she can see it possibly bubbling up, eventually.
“Before, I was like, no, I’ve seen people die before. But when you step back and look at it, you’re like, yeah, but every single one of your patients dying? That’s different.”
Stephanie Frater: No life outside COVID-19 right now
Stephanie Frater, 44, just came off a five-day run in a COVID-19 unit at Banner University Medical Center in Phoenix.
The traveling nurse, who worked in New York before coming to Arizona to help, is worried about a patient.
That worry is constant these days. Sometimes, she’s getting patients who can’t speak because they’re intubated, and nurses don’t know much about who they’re helping.
She recommends people start carrying a card in their pocket when they go out that lists medical conditions, medications, allergies and contact information for family members, just in case there’s an emergency.
When patients can have visitors, those visitors play a big role in sharing information to health care workers and boosting a patient’s spirits. When visitors can’t be there, Frater and other nurses take on an even more personal role.
“I know for a fact that he has no family member. And I’m just hoping when I get back to work that he’s still there,” she said. “I’m worried about him as if he is my family. I’m worried. I’m scared for him. I’ve become his family. And I don’t want him to think I abandoned him.”
She asks other nurses, and other nurses ask her, to check in on their patients when they take a day off.
She’s had another nurse literally wipe the sweat off her forehead while she was outfitted in her personal protective gear.
She lives in a hotel in Glendale with a bunch of other traveling nurses who have come to Arizona to assist hospitals as they fight increasing hospitalizations.
These nurses have become like family. They commiserate after work, they watch TV together.
“There is no life outside of this room or COVID for me right now,” Frater said.
When Frater, who is from Orlando, got to New York, she was dropped into the middle of something completely foreign: a new virus that challenged seasoned professionals and stretched resources thin.
When she got to Arizona, it wasn’t as shocking for her, though she knows nurses here are as shocked as she was at first. She had learned a bit about the disease and wanted to share that knowledge with people who were in the position she was in when she first started working with COVID-19 patients.
The hospital seems just as busy here, and she has seen it grow busier in the three weeks she’s been in Arizona.
And in New York, she said her patients were, on average, in their 50s and 60s. Here, they’re younger. Here, she’s had about 20 patients so far, and only seen one discharged.
“I’m seeing a 40-year-old father that went to work. I’m seeing a 30-year-old mother who went grocery shopping,” Frater said.
For New York to start changing the tide on COVID-19, it took everyone, she said. It took every person, every worker, every government official working together to minimize the spread of the virus. Arizona needs that now, she said.
“We’re in this together. Until we honestly operate like we’re in this together, every single person, not just health care workers, not just patients, every one of us, we’re in this together. And we can beat this if you take that mentality and we all stand as one united army and be in this together and do our part.”
Marcie Gest: Patients fine one minute, tanking the next
When Marcie Gest returned home af
ter working for eight weeks as a nurse treating COVID-19 patients in New Jersey, she sought out a therapist.
By then, the 32-year-old nurse had lived through chaos, seeing deaths every day working on the COVID-19 floor, and knew she needed help to process it.
She returned having watched patients die, being the only person who could be there with them in person while holding a phone so their loved ones could say goodbye. And as sad as it was, she then had to move quickly to the next three or four patients waiting for her care.
“The problem is, everybody calls nurses that are taking care of these COVID patients heroes and all this stuff, but in reality, anybody that is taking care of these patients, they’re going to be traumatized,” Gest said.
She’s found there’s a lot of self-doubt and questioning that comes along with treating these patients, wondering if there was more you could have done to help.
Nothing seems straightforward about this disease. And the list of symptoms that can come along with COVID-19 has continued to grow as the understanding of this new disease grows.
“A patient can be fine one minute and then the next minute, for whatever reason, something happens, and they just go down the toilet and they just are suddenly unable to breathe,” she said.
She returned to find she had been replaced at her previous job, at a hospice company. She’s now working in the emergency department at Banner Casa Grande Medical Center.
The patients here don’t seem as sick as the ones she saw in New Jersey, although they do seem to skew a bit younger and some have no co-morbidities.
She treated everyone she took care of in New Jersey as she would want her family to be treated. But now that the virus is so widespread back home, she’s started wondering when someone will walk through the door whom she knows personally.
When she left New Jersey, she remembered saying that she hoped nurses from other places would be willing to do what she had done if Arizona ever needed help.
“If ” became “when” as Arizona’s cases and hospitalizations continued to climb in June.
“I didn’t necessarily think it would actually happen where we would need help, but I’m glad that there are people that are still willing to come and help us,” Gest said.
Bridget Harrigan: Connecting with her eyes
Bridget Harrigan started feeling COVID-19 symptoms a couple of weeks into her stint as a travel nurse at Banner University Medical Center in Phoenix.
The 27-year-old was in “crazy denial” that she could be sick, despite working with these patients every shift. She didn’t want to be forced out of work by the virus at a time when her help was needed.
She made it through six weeks in a COVID-19 unit at the hard-hit Elmhurst hospital in New York. She couldn’t be getting sick now.
The first day she had a fever and felt sick, she took a hot shower to help her cough out the crud, and she was crying.
She wasn’t quite sure what the tears were about at first, but then she realized she had told a few patients that she would be back to work after one day off, and they seemed relieved she’d be back soon. Since she’s positive for COVID-19, she’s not coming right back to work.
“In New York, a few of my nurse friends there, we all kind of had this general belief: Literally anytime that we had a day off, our patient died. Or it would even get to the point where, if you take a lunch, your patient’s going to code, because it would happen,” Harrigan said.
Connecting with patients when you’re decked out in masks and gowns can be difficult. In New York, while she comforted, sang and spoke to her patients, they couldn’t really reciprocate
because they were often sedated and on ventilators.
Here, patients are sometimes awake and speaking to her. And they’re often anxious and nervous about what comes next.
“I can’t tell you how many times I’ve been asked point blank, am I dying, or am I going to die here, and am I going to see my family again,” she said.
She had one patient who was having a panic attack. Harrigan knelt on the ground in her full isolation gear for about 45 minutes so she could be eyelevel with her.
For Harrigan, it’s all about the eyeballs. With all of the required protective gear, the eyes do a lot to communicate.
“Sometimes, seeing a nurse who is fully gowned up in what looks like riot gear start to cry, or sometimes seeing their eyes water as they’re telling you that they’re there for you, is medicine enough,” she said. “And I personally find that it’s helped my patients more to see me as another human being who’s capable of feeling fear for them, feeling compassion for them.”
When she first got to Arizona, the situation in the hospital wasn’t as chaotic as it was when she arrived in New York. But she has seen the hospital grow busier, the patients grow sicker, and COVID-19-positive patients skew younger since she got here in mid-June.
During her last shift, she had two patients who should have been moved to a higher level of care, but couldn’t because there weren’t ICU beds available. Resources aren’t being rationed, but it doesn’t feel far off, she said. The recruiter whose post she saw about Arizona needing nurses called it the next New York. It feels like it could be, although everyone in the hospitals here is trying to prevent that, Harrigan said.
And still, despite how scary it feels in the hospital, it doesn’t seem scary enough to convince civilians in Arizona to operate differently, she said.
She was driving behind a car after an especially hard shift one day when she got cut off by another car. She noticed a bumper sticker on the car that said “#UnmaskArizona.” She felt defeated and frustrated.
“I know this is just one lady, but she represents a lot of people. And I don’t know what else to do. Just keep doing this, I guess, but how can I touch more people, how can I convince more people that it’s real?”
Marc Jebousek: Always ready, never closed
Marc Jebousek started getting text messages asking for people to pick up extra shifts at his hospital in Arizona while he was still in New York.
The 40-year-old emergency room nurse knew he would be seeing higher numbers of COVID-19 patients by the time he returned here.
He worked in the emergency department at Bronx Lebanon hospital in New York, where ICUs were full and patients were often held in the emergency department, from April to June.
The hardest part of treating these patients was losing his personality under a gown and mask, he said. It’s not possible to flash someone a smile and show you’re friendly and there to help them when you’re masked up.
At the time, New York City was empty. He walked through an empty Times Square. It was eerie to see such a usually busy place completely void of people.
The emergency department where he works here, at Banner Desert in Mesa, seems to be busier than normal, he said.
The hospitals here tend to be newer than those in New York, and they seem to have more space and ability to handle the influx of patients, he said.
And the emergency department never turns anyone away; that’s the job, and it’s often a busy one.
He wants Arizonans to know that if they’re sick and need to come to the emergency room, people like him are ready to help.
“We don’t get to close, we don’t get to say no, wait outside,” Jebousek said. “We’re like the Statue of Liberty: Bring us your tired, your hungry, your sick, your poor. We’ll do our best every day to bring in as many people as we can.”
He sees lots of misinformation floating around Facebook about the virus, and people who seem to glom on to halftruths or baseless home remedies instead of facts.
But he understands that people are just trying to do their best and manage their way through this tough time.
“It’s been a hard road, and I hope we all get through this. Because I would really like to go back to work and not have to wear a mask all shift. I would really like to be able to go back and go to restaurants and spend time with my friends and family and spend money at small businesses.”